Archive for the 'Coronavirus' Category

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If this trend goes on Johnson’s CON government will soon have a net negative approval rating

Tuesday, May 12th, 2020

Ministers struggling to maintain public support

The above chart is based on the weekly YouGov polling in which those sampled are asked to state whether they approve or disapprove of the government. As can be seen at the start of the lockout there was considerable backing for what Johnson had done and the policies that were being pursued. This has now moved from a net 26% to 7% in the latest survey in seven weeks.

It looks as though that the confidence that the bulk of the public had, up including those who didn’t go CON at the last election, has been receding and is now heading to even and perhaps even below.

This can be put down to to a number of highly publicised issues such as the lack of PPE equipment for NHS staff , the difficulties ramping up the level of testing and the emerging details of a massive death toll amongst those in care homes.

But it has to be said that in spite of everything Johnson and his team are still there are in positive territory.

The Tories continue to have large voting intention leads.

Mike Smithson



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Saving lives and protecting the NHS

Tuesday, May 12th, 2020

In Lord Denning’s 1980 judgement preventing the Birmingham Six from suing the police for injuries while in custody, he stated: 

Just consider………if their action were to proceed to trial………If they won, it would mean that the police were guilty of perjury; that they were guilty of violence and threats; that the confessions were involuntary and improperly admitted in evidence; and that the convictions were erroneous…….That was such an appalling vista that every sensible person would say, ‘It cannot be right that these actions should go any further’.”

It is what happens when an institution is seen as more important than the purpose for which it was set up or the people it is intended to serve. Denning could not countenance his “appalling vista” so he turned away from the more important concept: “Let justice be done though the heavens fall.” If it was not quite Britain’s Dreyfus affair, it shared many of the same characteristics: honour and reputation were seen, especially by those most closely linked to the institution, as more important than its actual conduct; challenge was most unwelcome. It is a failing to which all institutions are vulnerable.

So to the NHS. It is worth saying at the outset that the work, dedication and sacrifices of those working in it during this pandemic are worthy of praise and gratitude. It is possible to criticise an institution or the decisions taken at a policy level without demeaning its employees’ work and professionalism. Indeed, this is necessary if employees’ efforts are to be really worthwhile. Ultimately, any system is there for the benefit of its users, to serve the purposes for which it exists, not for those who work in it, however heroic they may be.

Protect the NHS” has been a key message. Ahead of, curiously, “Save Lives”. The reason is that, were the NHS to become overwhelmed, lives (whether of patients or health workers) would not be saved. To that extent, this policy appears to have been a success. But it has come at a cost – a cost which may well mean that the lives saved have not been as numerous as they might have been. Was this cost unavoidable or was it, in part, the result of policy decisions taken? There are three (out of the many needing thorough examination in due course) worth looking at now.

A Too Successful Message?

It’s not easy to calibrate people’s responses, even to the most carefully crafted message. People have stayed away from GP surgeries and hospitals. Out of fear or because their health issues were not that serious or health services were not available. Or because they took to heart the government’s message, because they thought they were helping. In some cases, this will not have mattered. But in others, the delay may well have meant people dying at home or not having symptoms treated and developing more serious conditions than otherwise or enduring pain or losing out on necessary treatment. In health, delay is not always a consequence-free option. This may have been inevitable and is now being remedied. But the consequences of delaying or removing treatment needs to be added into the balance at the the final reckoning.

Staying at home when ill 

The explicit advice from the 111 helpline anyone with Covid-19 symptoms was to stay at home. Only when a person’s condition became serious did hospital admission happen. Was this right? The risks of such a policy decision are that the more seriously ill a person is when they come hospital, the poorer their chances of survival or the greater the risks of surviving with long-term health damage. There is also a greater chance of them passing on the virus to others while at home. Delaying admission until absolutely essential was not Germany’s approach which was to intervene, not necessarily always via hospital admission, at an earlier stage, a practice enormously helped by its much more effective and wide-ranging testing regime. 

Both of these decisions by politicians and health officials were explicitly a rationing of health care because of a lack of capacity. Any state funded health system will, in some way or other, ration health care, a point often overlooked in discussions about structures, targets and monies spent. Covid-19 has made this explicit and in the most brutal way possible. When it arrived, the NHS did not have sufficient ICU capacity. There was also insufficient testing capacity – though this was only recently admitted. The decision was therefore taken to divert NHS resources to building up ICU capacity and limiting access to hospitals and GPs in the meantime. This certainly protected the NHS and patients from the distressing scenes seen in Italy but at the cost of hidden suffering and death elsewhere. Nowhere has this been more apparent than in care homes.

Why are social care and NHS not integrated? 

You may well ask. Decisions by successive governments to do nothing effective about social care, other than bunging a bit more money at councils from time to time, commissioning reports from the eminent then ignoring them were made long before this virus was a twinkle in its bat mother’s eye. But the virus has cruelly exposed these failings. Policies – lockdown, shielding vulnerable groups, staying away from Granny so as not to infect her – designed to protect those most at risk have been undermined by a policy which has treated care for the elderly and sick at the end of their lives as somehow distinct from and less important than health, an unfortunate after-thought. It’s as if we labelled pregnancy, birth and a child’s early years nursery care and left it largely to parents to sort out. If babies die, too bad: easy enough to make another. As easy as dismissing the elderly “bed blockers”.

Care for the elderly is not an optional extra when a virus dangerous for them comes. Why did NHS England give specific guidance on March 7 to “urgently make available 15,000 hospital beds nationally by discharging anyone who was medically fit to leave without thinking of the consequences for care homes? Were patients sent there without testing for the virus even if they had symptoms? Or even if they had them or were known to be infected? And what did the Department of Health think would happen when it said on April 2nd that negative virus tests were “not required” before discharging people into a care home? What did they think would be the consequences of not making provision for PPE for care home workers? Or of having no policy for managing the movement into and out of care homes of care workers? Or of reduced access to GPs? Or of not having family members able to visit and speak up for their relatives? 

However laudable the desire to protect the NHS is, its failure is that the NHS’s patients are too often defined – unthinkingly perhaps – as excluding some of the most vulnerable, especially in a pandemic. It’s not as if the government was not warned, as the report into Exercise Cygnus in 2017 stated. Care homes, their need for staff, for a plan, the dangers of discharging patients to them were all expressly raised as serious risks – but little was done.

So when a crisis came and health care had to be rationed, hospitals were given priority. Patients in hospitals over those in care homes. Hospital workers over care home workers. Social care took its accustomed second place in our priorities. And that is, in part, why there has been an epidemic of the virus among the most vulnerable group, the group which government policies were ostensibly designed to protect. Rather than cocoon the most vulnerable, they were left horribly exposed.

Perhaps in reality this is no different from what has always the case. This time we have noticed. This time, as Boris has said, we “bitterly regret” what is happening. Perhaps it could not have been otherwise. Other countries have suffered similarly high rates of care home deaths.

There is little good likely to come from this virus. Maybe one thing which might is that we – finally – do something serious about how we care for the old, the disabled, the vulnerable rather than simply talk about it.

CycleFree



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COVID-19: With England faring the worst in Europe Boris’s TV address raises more questions than it answers

Sunday, May 10th, 2020


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Get well soon, Prime Minister

Sunday, May 10th, 2020

Six words brought down a Prime Minister: “Don’t you think she looks tired?” Alright, she was the entirely fictional Prime Minister Harriet Jones in Doctor Who, but the point is a good one.

Boris Johnson does not need the interference of a Time Lord for the public to be questioning his health. He looks terrible. For many years, he has traded off looking rumpled. He now looks dishevelled and haunted.

Poor man. He succumbed to exactly the virus from which he was supposed to be trying to protect all of us.

Even then, the Prime Minister did not take the threat seriously. He stayed in harness, even allowing himself to be pictured ritually clapping the NHS one Thursday evening. Viruses, however, are no respecters of persons and by working when he should have been resting, he may well have made himself iller. As we now know, he was rushed to hospital, then to intensive care.

Fortunately, he has made a recovery. Evidently it is nothing like a full recovery yet. The usual Frankie Howerd-like fluency of apparent dithering that is tightly scripted has been replaced by stumbling and hesitancy.

If he were doing a normal job, any decent boss would be telling him to stay home and rest up until he felt much better. It’s hard to imagine that he’s making decisions with a cool head and clear thinking.

Being Prime Minister is not a normal job. He doesn’t have an employer and he doesn’t have an employment contract. He doesn’t even have a job description. Most of the few statutory references to the role of Prime Minister are in setting his pay, pension and the perks of the job (like Chequers). So no one can force him back to the desk and no one can stop him from coming back to work before he is fit to work.

Why has Boris Johnson rushed back to work so quickly? He’s hardly shown much of a work ethic before now. So we might presume that there are one or more big strategic decisions that need to be taken where he (or those around him) believes his input will be decisive.

What might those decisions relate to? They may not be visible. One subject, however, has been the subject of considerable debate in the rightwing press – when lockdown is to end. A casual glance at the Sun, the Mail and, especially, the Telegraph will show you that forces of conservatism are pressing to lift up the shutters.

If Buzzfeed is right, the unnamed politicians arguing for this, supposedly a majority in the Cabinet and the Parliamentary Conservative party, were opposed by Matt Hancock, Dominic Cummings and Boris Johnson himself.  Buzzfeed confusingly dubs those who argue for fewer restrictions even though more people will die as a result “hawks” and those who argue for greater restrictions with expensively necessary financial support “doves”. “Snakes” and “ladders” would be closer to the mark.

This battle is manifesting itself in the new guidelines we’re getting.  “Stay home” is being replaced with “stay alert”. This new vacuous message has received a widespread panning and the government has hurriedly have to issue glosses to the word “alert” that do not appear in the Oxford English Dictionary.

The vacuousness of the slogan is not the problem, however. The problem is the vacuum in the policy. The government has simply not made up its mind what it expects of its citizens. Clearly there has been a shift from “stay home”.  But to what? Are we to resume any social activities, and if so what?  How much inessential work can be resumed? Can married men in their 50s start visiting their mistresses again?

This debate continues, and now the risk of serious public confusion is substantial. If this is going to be sorted out, the Prime Minister needs to be able to use his political heft to settle it. For that, he needs to be at full strength. So rest up, Prime Minister. A nation’s health as well as your own depends on it.

Alastair Meeks




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The voting intention polls since LAB got its new leader

Friday, May 8th, 2020

Although there has been no big breakthrough for LAB since double election loser Corbyn was replaced by Starmer a positive is that the party is now out of the 20s and the CON share is edging down.

Inevitably during a crisis like this one it is hard for the opposition leader to get a look in because just about the only story being covered by the national media has been the pandemic.

A worry for the Tories is the growing negative numbers that we are seeing on aspects of the government’s handling of the crisis and the impression of a lack of preparedness and ministers appearing to wing it day by day.

Normal politics won’t resume until life starts to get back to normal.

Mike Smithson



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The pandemic costs: Who bears the risk?

Wednesday, May 6th, 2020
A drive-in test cente

A look at the huge financial commitment

One of the criticisms of the 2008 bank bailouts was that banks had privatised the profits but nationalised the losses. It wasn’t entirely accurate: shareholders and plenty of bank staff lost money and jobs. Had banks failed, plenty of other businesses would have failed too. But it was broadly true. Those whose key job it was to manage risk failed abysmally, took insane risks, pocketed unjustifiably high rewards which did not accurately reflect the cost of those risks and left others – far less able to bear the burden – to pay for it all, for a decade or more. The resulting sense of unfairness, resentment, of the costs being borne by the “little people”, of the “Too Big to Fail Haves” who were at fault getting away with it has informed politics ever since, in ways largely unanticipated at the time.

Is something in reverse happening now? The lockdown policy’s benefits – the containment of the virus and its ability to spread and cause death and harm – are for everyone. But the losses are largely privatised and not equally shared. The economic losses are principally borne by private businesses and individuals, whose ability to earn has been stopped or severely limited, many of them least able to bear such losses and unable to insure themselves against a government decision. Any activity dependent on social interaction unmediated by technology  – and that is the majority of them – has  been rendered largely unviable. For now. Maybe forever, depending on what decisions government takes to end the lockdown – and thereafter.

There are other losses too: the lives saved in the government’s advertising trinity refer to those not catching this virus. Those with other health conditions have – temporarily – been ignored, a delay which may prove fatal; the harm done done to yet others by these measures is unknowable and may remain largely invisible. The virus’s direct consequences are easy to see. Much harder to draw a clear line between isolation or unemployment and their consequences.

The government has not been blind to these. From a halting start (loans, whether guaranteed or not, have never been the right answer to a permanent loss of income) its furlough scheme (and limited grants) have been an attempt to mitigate some of the losses suffered. It may not have given a sweeping Macron-style reassurance but it is trying to do something to help those affected and ensure consent for the lockdown measures needed. 

However welcome these steps are, they are not up to the scale of what is needed. This is not a short-term emergency, even if a vaccine is eventually found. Take-up of the loans has been poor, for obvious reasons: who wants to take on debt when you have no income and may have no viable business. This has now been explicitly recognised with business viability no longer being a criterion for such loans. The government may as well call them grants now and be done with it. Few of them are likely to be repaid. A cynic might say that the scheme suits the government very well: it looks generous while contributing relatively little; it can blame businesses for not availing themselves of the opportunity; it can ignore the scheme’s inherent flaws. 

The furlough scheme is better. But it is focused on saving jobs or, more accurately, postponing redundancies. There is little for businesses to replace the permanently lost income and even businesses which are temporarily closed have continuing costs. Postponed taxes still have to be paid. Reserves are being used up; those without will soon need to decide whether to close for good. One worthwhile amendment would be to allow furloughed employees to do some work and provide support for reduced hours up to the full salary or thereabouts, thus allowing some economic activity to continue (as in the Swedish version). Not that the Chancellor has to look that far for an example of something similar. Tax credits anyone? 

Whatever the inadequacies, how long can this support can go on for? Financial support and the lockdown have to go hand in hand. A gradual easing of restrictions may permit a gradual easing of financial support. If so, consistency of messages (not a government strong point) is critical. But there are choices to be made which go far beyond the daily “Are we there yet? questioning.

If activities are made lawful again in order to restart, what will the government’s message about them be? 

To the public: Yes – they’re lawful but very dangerous so don’t do them. 

To businesses: You can operate lawfully so no more support for you. 

How can that possibly work? Two-faced would be a polite way of describing such a message. Confusing and brutally dismissive would be more accurate. And what will be the response be? 

Public: How can you expect us to work, live, travel in a way that puts us at risk? 

Businesses: You’ve made us unviable. Forget the law. We’re shutting down because of what you’re saying. It is a cruel deception to say that it is our choice.

It is an exquisitely painful dilemma. The government could adopt a brutally Darwinian approach. The virus has changed how life is lived. Businesses will have to adapt and if they cannot they die. If that means a big rise in unemployment and bankruptcies and financial hardship and pain for very many voters, too bad. Other businesses will thrive or arise in their place. 

True. Eventually. But the economic, social and political costs of such a course of action will be vast. It will likely be the Amazons of this world thriving, exactly those who benefit from the disliked globalisation, those least likely to pay the taxes needed to pay for the transition to this post-virus world. The resentment, bitterness and sense of unfairness will be even greater. The losses will not be equally shared: particular sectors, regions and groups will be hardest hit, many of them in newly Tory constituencies. A decision to withdraw financial support or to make it impossible – whether through law or social pressure – for some businesses to operate is not an Act of God. It is a political choice, for which the government will be held responsible. Just as austerity was or – more importantly – was perceived to be. A government which has declared austerity dead, which talks about levelling up forgotten parts of the country would be inflicting austerity cubed on its voters, would be fatally undermining the promises and hopes on which it was elected.

Continued financial support then?  If so, this will likely need to be phased – both by sector and over time – and with the aim of helping restore economic activity and allowing business to adapt to new realities. The sequencing and communication will need to be intelligently planned, competently implemented and sensitively communicated. (Implying – as reported in today’s Times – that people legally ordered not to work have become “addicted” to furlough, as if they had a choice, suggests the government has some work to do in this regard.)

Maybe some of the support will need to be in the form of compensation to those businesses unable to operate – and not just to the legal owners of but the workers within the businesses. There are not many precedents for such compensation. (The payments made to slave owners – but not the slaves – when slavery was abolished, perhaps? Hmmm. When smoking was forbidden, no compensation was paid – but businesses had time to adjust. And smoking was hardly key to most businesses anyway.) Why compensation? Well, why not? Give those entrepreneurs and their staff the opportunity to do something different, develop new businesses, encourage ideas and fresh opportunities. Give them hope.

Lifting lockdown is not just about reopening a few workplaces here and there or allowing people to meet friends. It’s about trying to keep an economy and society going in a way which makes people feel that the government is on their side, is trying to help – not punish – them and is not letting those most affected bear the risks of something which is not their fault and for which they could not have planned.

Unprecedented? Yes. Expensive? Yes. Complicated? Yes. A temporary nationalisation of large parts of the economy? Yes. Problem-free? No. It is all these things and more. 

But the cost-free easy alternative is ……..?

Cyclefree



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Boris is going to struggle dealing with the ever so polite but forensic Starmer

Wednesday, May 6th, 2020

Today the new Labour leader, Keir Starmer, faced Boris Johnson for the first time at PMQs. Last week the PM wasn’t there because of the birth of his new baby. 

This was no ordinary session because clearly, the House was largely empty as a result of the coronavirus pandemic and some MPs were asking their questions by video links.  It also came on a difficult day for the government as the UK became the top of the league table for the number of coronavirus deaths in Europe.

Starmer has a style that we have not seen before by any previous opposition leader in recent times. As you would expect from a former Director of Public Prosecutions he’s very much on top of his brief  has all the facts at his fingertips, and was able to put the Johnson under quite a lot of pressure in a quiet and reasonable manner.

It’s going to take some time before the impact of Starmer will be seen by the general public but the signs from this morning should be quite concerning for the Conservatives and  positive for LAB. I actually think that either Theresa May or David Cameron would be better dealing with the Starmer approach.

Mike Smithson



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Not good pandemic front pages for the government this morning

Wednesday, May 6th, 2020

So far during the coronavirus crisis the government has had pretty good front pages. We are facing a massive challenges as a nation and generally papers from across the political spectrum have until now been broadly supportive. That, I wonder, might be about to change.

The resignation of one of the government leading scientists together with the the UK death toll now being the highest in Europe combine to make this quite a difficult day for the government which, of course, sees Boris Johnson  facing Keir Starmer at Prime Minister’s Questions for the first time. How both men will approach this will be a good pointer. 

The real problem with the scientist story is not that he was having an affair but that he broke the lockdown travel rules. You can’t expect the public at large to follow this extremely restrictive regime if people in such positions don’t think it applies to them. Nigel Farage is right to be criticised on the same grounds for his unnecessary travel. 

The big shadow hanging over the government remains. That is the lateness of the UK to clamp-down might have led to thousands of unnecessary deaths. How Boris spent a lot of his time in February is going to be an ongoing target for criticism and something that is not going to go away. 

 

Mike Smithson